{"doi":"10.1093/eurheartj/ehad200","title":"Outcomes of patients with atrial fibrillation and ischemic stroke while on oral anticoagulation","abstract":"AIMS: The prognosis of patients with atrial fibrillation (AF) and ischemic stroke while taking oral anticoagulation is poorly understood. This study aimed to characterize the outcomes of patients following a stroke event while on oral anticoagulation. METHODS AND RESULTS: Individual participant data from five pivotal randomized trials of antithrombotic therapy in AF were used to assess the outcomes of patients with a post-randomization ischemic stroke while on study medication (warfarin, standard-, or lower-dose direct oral anticoagulant regimen) during trial follow-up. The primary outcome was recurrent ischemic stroke after the first post-randomization ischemic stroke. The primary analysis included 1163 patients with a first post-randomization ischemic stroke while on study medication (median age 73 years, 39.3% female, 35.4% history of stroke before trial enrollment). During a median continued follow-up of 337 days, 74 patients had a recurrent ischemic stroke [cumulative incidence at 1 year: 7.0%, 95% confidence interval (CI) 5.2%-8.7%]. The cumulative incidence of mortality at 3 months after stroke was 12.4% (95% CI 10.5%-14.4%). Consistent results for the incidence of recurrent ischemic stroke at 1 year were obtained in an analysis accounting for the competing risk of death (6.2%, 95% CI 4.8%-7.9%) and in a landmark analysis excluding the first 2 weeks after the index stroke and only including patients without permanent study drug discontinuation since then (6.8%, 95% CI 4.6%-8.9%). CONCLUSION: Patients with AF and ischemic stroke while on oral anticoagulation are at increased risk of recurrent ischemic stroke and death. These patients currently have an unmet medical need.","journal":"European Heart Journal","year":2023,"id":319596,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":54,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8302,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":55163,"name":"Stefan H. Hohnloser","orcid":"0000-0001-5030-3315","position":1,"is_corresponding":false},{"id":56149,"name":"John W. Eikelboom","orcid":"0000-0003-4126-1285","position":2,"is_corresponding":false},{"id":341408,"name":"Anthony Carnicelli","orcid":"0000-0002-9805-4562","position":3,"is_corresponding":false},{"id":341410,"name":"Robert P. Giugliano","orcid":"0000-0003-4110-7675","position":4,"is_corresponding":false},{"id":260564,"name":"Christopher B. Granger","orcid":"0000-0002-0045-3291","position":5,"is_corresponding":false},{"id":850371,"name":"Josephine Harrington","orcid":null,"position":6,"is_corresponding":false},{"id":728420,"name":"Ziad Hijazi","orcid":"0000-0002-7420-743X","position":7,"is_corresponding":false},{"id":264819,"name":"David A. Morrow","orcid":"0000-0002-9589-5382","position":8,"is_corresponding":false},{"id":302877,"name":"Manesh R. Patel","orcid":"0000-0002-2393-0855","position":9,"is_corresponding":false},{"id":857638,"name":"David Seiffge","orcid":"0000-0003-3890-3849","position":10,"is_corresponding":false},{"id":256548,"name":"Ashkan Shoamanesh","orcid":"0000-0002-2802-1626","position":11,"is_corresponding":false},{"id":29509,"name":"Lars Wallentin","orcid":"0000-0003-0378-6531","position":12,"is_corresponding":false},{"id":1028632,"name":"Qilong Yi","orcid":"0000-0003-0333-4076","position":13,"is_corresponding":false},{"id":56134,"name":"Stuart J. Connolly","orcid":"0000-0002-7377-335X","position":14,"is_corresponding":false},{"id":1028631,"name":"Alexander P. Benz","orcid":"0000-0003-2555-1266","position":0,"is_corresponding":true}],"reference_count":37,"raw_metadata":null,"created_at":"2026-07-19T01:07:12.004111Z","pmid":"37038327","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}